How to avoid next gout attack with short term medication treatment?

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Hi Everyone

I am an acute gout sufferer, nowadays facing my 4th gout attack with the gap of one year. In my first two attacks I did not realize it was gout but my 3rd gout attack was very severe and therefore I diagnosed it was gout. I did not take proper medication to bring my serum uric acid values down in the range as they were making me sick. After one year(now) I got another sever attack in my right foot toe. Doctor had advised me to take febuxostat (uristat 40 mg tablets) once daily. I know these medicines are long term treatment. Can someone please give me an idea how long should I take this medication? How long after taking this medicine I will be able to control my uric acid levels with proper diet and exercise? I want to cure my gout naturally.

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  • Posted

    So sorry that you are experiencing this painful, horrible disease. First and foremost, you need to begin to eat clean. Cut out all Red meat, Seafood, Beer and begin to eat veggies and small amounts of chicken. Drink lots of water, and go to the store and get some cherry supplements. This didn't entirely do it for me. I had to go on a steroid to control mine, but it did help. I continue to eat clean and I have a uric acid level a year later of 5.7. I feel great. I drink white wine now. I do not eat red meat at all. I eat very little fish. You just need to figure out what your triggers are. God Bless you!

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    • Posted

      At 5.7 you may feel great, and you are below the level of gout attacks. But you are almost double the level considered to be healthy by NICE and are at risk of a variety of serious illnesses a decade down the line.

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    • Posted

      Dear Redshells67

      Thank you for your comment. My uric acid leve is 7.9 mg/dl. Which medicine did you take to bring it down? I am taking two teaspoons of apple cider vinegar in a cup of water two times a day. Someone told me it will bring my levels into the range.

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    • Posted

      At 5.7, this is within normal range and my doctor said that he is extremely happy with this level. I see him every 6 months and have blood tests to monitor my levels. I have had zero attacks so far in a year. I monitor my gout by diet. I am on no medication, so my doctor is fine with this.

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    • Posted

      I am really sorry to hear that you have the bad luck to have such a poor GP.

      I will pass on to you the advice given to me by the rheumatologist who I first saw at diagnosis. He said lots of GPS consider gout to be a minor inconvenience of middle aged men, not a life threatening long term illness. If you find one that thinks that, or thinks that lowering urate to its minimum then find another GP. I dumped 2 before landing on this one.

      GPS are supposed to be following the advice of NICE, not their own personal half remembered treatment protocols. NICE state:

      Allopurinol is the recommended first-line urate-lowering agent.

      Start at a low dose and titrate upwards (where tolerated) every four weeks until the serum uric acid (SUA) level is below 300 micromol/L.

      For people with renal impairment starting dose and titration guidance may differ.

      Your doctor seems to be unable to read the advice given. Furthermore and more worryingly obviously doesn't understand the basic medicine behind this advice. This advice is at least a decade old, and indicates a doctor that doesn't bother to keep up to date.

      The reason s/he is happy with 5.7 is because for a healthy male under 6.0 will stop gout and keep you out of the way. There is mounting evidence that high blood urate itself without gout should be treated, but that is resisted because it would involve treating huge numbers of symptomless patients. The reason 300 is selected as the target as this is the healthy level for a young adult, and the point where the inflammation in the blood vessels, heart, brain, kidneys is lowest and chance of heart attack lowest.

      FYI for most people the effective dose of allopurinol is 300 mg. The 100 mg tabs are supposed to be used only for the first month check the patient isn't allergic. Good doctors suggest that during the first couple of weeks that 100 mg tablet is split into 4 to reduce the chance of a severe reaction to allopurinol.

      I wish you good health.

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    • Posted

      On the money again Rustygecko.

      Yesterday I had my first gout attack since starting Allopurinol in Feb. In a month on a 100mg dose I was down to 420 SUA from 600's and so then we went to 200mg - I'm due a bloodtest in a week so see how this is doing. I'm actually going to 300mg today because of this attack.

      Is a week long enough to stabilise on the 300mg do you think and get a valid blood test result?

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    • Posted

      The body adapts to the 300 mg in 24 hours But there's no point in having a blood test in under a few weeks from the end of an attack. Why? Because the blood urate precipitates into the joint thus reducing the urate in the blood, giving a false reading. Nice recommend a month before a test {from memory}.

      As for the cause of the attack? The strange thing is that changes in blood urate, both up or down, will cause joint precipitation. Following NICE advice, the patient should have low-dose colchicine to ward off any attacks. I found that one tab in the morning and one at night stopped any attacks. At first sign of any attack after I stopped the prophylactic dose, I just took one and if still signs went back to one in morning and one at night regime.

      Good luck.

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    • Posted

      I am sure that there are good probiotic reasons for cider vinegar, which could well help the bugs in your intestines.

      I alway think that with cider vinegar - anything that is that sharp and makes me shake my head like a dog with a rat - it must be doing me some good!

      But as for keeping blood urate under 3...its the 21 century meds doing that.

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  • Posted

    The good news is it doesn't have to be forever, but the bad news is it's hard to predict. Just do what you have to do today, take the meds and start improving your diet, and that's how you find out!

    Get a list of the high purine foods and put a copy right there in the kitchen where you can see it easily. Even some vegetables should be avoided. OTOH a little bit of red meat isn't all that bad.

    Some people say diet isn't even the issue, and for some people that's true, but if you're borderline then good diet can really help.

    Look into celery, and celery seed, and standardized extract 3nb as a natural treatment and a good part of any gout diet. At some point you could stop the pills and maybe rely on the celery, but you will probably have to watch your diet pretty closely for a long time.

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    • Posted

      Thanks you very much for your answer. Red meat and spinach triggered this attack. Now I have started to take febuxostat 40 mg tablets. I will be closely following my diet and update you guys if I could get any improvements.

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  • Posted

    I found no pattern in food for me. Nothing specific proved to be a trigger. It could be just one of those things... I generally even hate all the renowned trigger foods like beer and seafood! Allopurinol sorted me with seemingly no side effect or diet of veg and water!

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